the model for improvement joy whitlock · 2015-11-14 · the sequence for improvement spreading a...
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The Model For Improvement
Joy Whitlock
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Aims
• Review the Model for Improvement
• Practical session – develop PDSAs
• Have some fun
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Model for Improvement
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The Sequence for Improvement
Spreading a
change to other
locations
Developing a
change
Implementing
a change
Testing a
changeAct Plan
Study Do
Theory
and
Prediction
Test
under a
variety of
conditions
Make part
of routine
operations
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The MBFC Index
You will need a coin
And two free hands!
Just how competitive can you get?
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MBFC Messages
• If you do what you always did you will get what you always got
• It’s no good just trying harder
• Setting goals is important but you have to do something different/make a change
• All improvement requires change but not all change is an improvement
• Some variation is inevitable
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PDSA Cycles
• Breaking it down to small detailed tests of change.
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Overarching
AIM + 95%bundle compliance
Change Concepts, Theories, Ideas
Concept B
Bundle 1
Concept C
Bundle 2
Concept A
Assessment
Concept D
Bundle 3
Multiple change concepts for a single
Aim
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Multiple PDSA Cycle Ramps
Aims – 95% reliability with assessment on admission for all patients by 30th November 2012
95% reliability with all self caring patients on bundle 1 by 30th
November 2012
Assess
mentOwn care
before bed
Change Concepts
Own care in
bathroom
Own care at
bedside –
after
breakfast
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What changes can we make that will result in an improvement?
Develop the Plan…• Identify the first tests of change – what
will you do tomorrow?• How will you measure success?• State predictions• Who, what, where, when?• Describe data collection plan
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Whatcan you accomplish
by next Friday?
It all depends on the size and
scope of the planned change!
1 patient, 1 nurse, 1 doctor, 1 day
Start small
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Do• Attempt to carry out plan
• Document any problems or unexpected events
• Collect planned data
• HUDDLE - Capture feedback or observations from those conducting the plan
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Study
• Complete the analysis of the data by comparing your prediction with what actually happened
• Analyse feedback or observations
• Make suggestions
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Act• What will happen in the next PDSA
cycle?
• Develop change further?
• Test?
• Implement?
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Tips• Take the right action from what you
observe
• Use common sense
• Use the data (run charts) to engage others/celebrate success
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Whatcan you accomplish
by next Friday?
It all depends on the size and
scope of the planned change!
1 patient, 1 nurse, 1 doctor, 1 day
Start small
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Paper exercise
• My aim – 95% of you will reliably follow this process.
• My prediction/hypothesis – you will succeed–verbal instruction is all you need
• How will I measure success? Count the number of defective products or % of good products
• Test 1 - Close your eyes, listen and follow instructions.
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Reliability
• Paper exercise – simple process?• How can we reliably reproduce this paper
exercise?• What steps are involved? • Does everyone understand the instructions?• Can everyone carry them out?• How much variation is acceptable? • Perfection v good enough?• How will you know you have succeeded – is your
data definition good enough?
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PDSA Cycles – breaking them down
Set Aim – 95% people will be able to follow the verbal instructions.
Have a go……..
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Whatcan you accomplish
by next Friday?
It all depends on the size and
scope of the planned change!
1 patient, 1 nurse, 1 doctor, 1 day
Start small
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If you measure.....you can
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References/Resources
• 1000 Lives Plus website http://www.wales.nhs.uk/sites3/home.cfm?orgid=781
• 1000 Lives Plus Improvement Guides • http://www.wales.nhs.uk/sites3/page.cfm?orgid=781&pid
=47540
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Questions?
Thank You
• Joy Whitlock – global email
• UHW 029 20 745099